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Organization
PACIFIC CLINICS
Active
Organization
PACIFIC CLINICS
Active
Other names
Pacific Clinics Children's Intensive Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J. BALLA (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(626) 254-5000
Entity
Organization
Contact information
Practice address
1126 N GRAND AVE, SUITES B, C, D, COVINA, CA 91724-1551
(626) 967-1667
(626) 967-6027
Mailing address
800 S SANTA ANITA AVE, ARCADIA, CA 91006-6853
(626) 254-5000
(626) 294-1077
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7439A
—
CA
Enumeration date
02/27/2007
Last updated
09/23/2021
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